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Öğe Evaluation of DNA damages in congenital hearing loss patients(Elsevier B.V., 2021) Çağlar, Özge; Çobanoğlu, Hayal; Uslu, Atilla; Çayır, AkınIn the current study, we aimed to compare the level of genetic damages measured as micronucleus (MN), nucleoplasmic bridge (NPB), and nuclear bud formation (NBUD) in congenital hearing loss patients (n = 17) and control group (n = 24). The cytokinesis-blocked micronucleus assay (CBMN) was applied to the blood samples to measure the frequency of the markers in both groups. The frequencies of MN of hearing loss patients were found to be consistently significantly higher than those obtained for the control group (p < 0.0001). Similarly, we found significantly higher frequency of NPB in patients was obtained for the patient group (p < 0.0001). Finally, the frequencies of NBUD in patients is significantly higher than the level measured in the control group (p < 0.0001). Furthermore, the age-adjusted MNL, BNMN, NPB, and NBUD frequencies in the patients were significantly higher than those obtained in the control group. We observed that the frequency of MN in patients was positively correlated with NBUD frequency which may indicate a common mechanism for these biomarkers in the patient group. We found, for the first time, that there were statistically significant higher levels of MN, NPB, and NBUD in sensorineural hearing loss patients. Since the markers we evaluated were linked with crucial diseases, our findings might suggest that sensorineural hearing loss patients are susceptible to several crucial diseases, especially cancer. Furthermore, the results demonstrated the significance of the MN, NPB, and NBUD level and thus provides a potential marker for the diagnosis of congenital hearing loss patients.Öğe CHEST INJURIES ACCOMPANYING BLUNT SPINAL TRAUMA(Turkish Spine Society, 2021) Kapıcıbaşı, Hasan Oğuz; Malçok, Ümit AliObjective: Only a few studies in the literature have evaluated chest injuries accompanying blunt spinal trauma. We aimed to evaluate chest injuries observed concomitantly with spine injuries as well as reveal their clinical importance. Materials and Methods: Eighty-eight patients, who were treated and followed up by the authors after being admitted to the emergency department because of severe blunt spinal trauma, were evaluated retrospectively. Results: Data from a total of 55 patients [30 (54.5%) male and 25 (45.5%) female] who met the study criteria were included. The mean age of patients was 58±15.8. Falling from height was the most common cause of trauma in 32 patients (58.2%) and was significantly more frequent than other causes such as traffic accident, assault, non-vehicle traffic accident, and motorcycle accident (p<0.001). Spinal fracture was observed in 38 patients with severe blunt spinal trauma (69.1%), while ligament and other soft tissue damage was found in 17 patients (30.9%). Spinal fractures were significantly more frequent in the thoracic vertebra (n=28; 50.9%) compared to other regions such as the cervical and lumbar spine (p<0.001). It was observed that chest injury accompanied 33 (60%) patients who experienced blunt spinal trauma. When the thoracic region was classified as per injured tissues; rib fracture (n=10; 30.3%) and pulmonary contusion (n=6; 18.2%) were observed most frequently. Conclusion: Patients with thoracic spinal fractures should be considered at a high risk for chest injury, and this group of patients should be prioritized because of the possible life-threatening complications. In our study, we concluded that the rate of falling from height increased in the elderly group, as well as neurological losses. Moreover, the rate of neurological deficit following thoracic vertebral damage due to falling from height kept increasing especially in the elderly group.Öğe EFFECTS OF LUMBAR MICRODISCECTOMY ON SPINOPELVIC PARAMETERS(Turkish Spine Society, 2021) Malçok, Ümit Ali; Akar, AliObjective: One of the causes which accelerates spinal degeneration process is lumbar disc hernia (LDH). In this study, we observed the changes in spinopelvic parameters one month after single-level lumbar microdiscectomy (LM). Materials and Methods: Standardized bilateral standing scoliosis radiography images of 19 patients, which were performed before and 1 month after LM operation, were evaluated retrospectively. Sagittal vertical axis and coronal vertical axis distances, thoracic kyphosis, lumbar lordosis, pelvic incidence, sacral slope and pelvic tilt angles were measured with Surgimap software. Results: There was a positive correlation between pre-and post-LM values of all spinopelvic parameters included in the study. In comparative tests however, the difference was found to be not statistically significant. As a result, despite LM operation slightly improved spinopelvic parameters in the first month, there was not a significant change overall. Conclusion: LDH is known to worsen the degenerative process in spine. LM as a treatment option is seen to alleviate this degenerative process by slowing down the deterioration in spinopelvic parameters.Öğe New results for monogenic diabetes with analysis of causative genes using next-generation sequencing: a tertiary centre experience from Turkey(Springer, 2021) Karakılıç, Ersen; Saygılı, Emre Sedar; Sılan, Fatma; Önduç, Gonca Gül; Ağcaoğlu, UğurcanBackground: Although monogenic diabetes accounts for a small proportion of diabetes cases, accurate diagnosis may significantly change treatment. This study aimed to contribute to knowledge about the genotype-phenotype relationship in monogenic diabetes. Methods: This study used data from a tertiary centre in Turkey. Genetic analysis outcomes for 36 patients were evaluated. The panel included 23 genes related to maturity-onset diabetes of the young (MODY), neonatal diabetes, and some genes related to hyperglycemic hypoglycemia. The next-generation sequencing method was used after DNA isolation from the peripheral blood. Results: Mutations were identified in 19 (52.8%) of 36 patients. Of the 19 mutations, 7 (36.8%) were new mutations. A total of 20 cases met the MODY clinical criteria, and mutations were identified in 11 (55%) of them. In total, nine patients had more than one mutation. Mutations were identified on the ABCC8 (n = 7), PDX1 (n = 6), GLIS3 (n = 6), ZFP57 (n = 5), GCK (n = 4), HNF1A (n = 3), GLUD (n = 3), and HNF4A, KLF11, NKX2-2, and INSR genes (n = 1 each). Conclusion: Our findings highlight a broad clinical and genetic spectrum of MODY, and genetic analysis may provide a better understanding of diabetes and improve the individualised treatment approach.Öğe Comparison of Urodynamics Parameters with Intrafascial or Extrafascial Hysterectomy Techniques(Mary Ann Liebert Inc., 2021) Erin, Recep; Ünsal, Mesut Abdulkerim; Güven, Süleyman; Aran, Turhan; Bozkaya, HasanObjectives: The aim of this study was to compare urodynamics parameters at pre-and postoperative periods in patients undergoing intrafascial or extrafascial abdominal hysterectomy. Background: Hysterectomy carries the risk of damage to the pelvic splanchnic nerve, which leads to the development of urinary incontinence. Materials and Methods: Women scheduled for total abdominal hysterectomy were randomized to intrafascial (n = 24) and extrafascial (n = 27). All of the 10 urodynamics parameters investigated in the two techniques at pre-and postoperative periods were compared. p < 0.05 was chosen to represent the statistical significance for each of the variables. Results: We observed by urodynamics investigation at preoperative and sixth month postoperative periods no urinary incontinence in patients subjected to intrafascial or extrafascial total abdominal hysterectomy. There was no difference between the two techniques with respect to maximum detrussor pressure, maximum abdominal pressure, strong micturition requirement, vesical compliance, detrusor compliance, maximum vesical pressure, first sensation of bladder filling, first desire to void, and strong desire to void (p > 0.05). Maximum bladder capacity in the intrafascial technique was significantly higher than in the extrafascial technique (p < 0.05). Conclusion: No significant relationship was found between the two groups with respect to increase of stress or urge urinary incontinence symptoms and subsequent incontinence after hysterectomy.Öğe The Impact of Stone Density on Operative Complications of Retrograde Intrarenal Surgery: A Multicenter Study with Propensity Score Matching Analysis(Mary Ann Liebert Inc., 2022) Başatac, Cem; Özman, Oktay; Akgül, Hacı Murat; Özyaman, Onur; Çınar, Önder; Can, Günay; Sancak, Eyüp BurakBackground: The aim of the study was to evaluate the impact of stone density on operative complication rates in retrograde intrarenal surgery (RIRS). Materials and Methods: A total of 473 consecutive patients undergoing RIRS for the treatment of upper tract urinary stones were included. To adjust for baseline confounders, one-to-one propensity score matching was performed. After matching, the patients were divided into two groups according to stone density (low density [LD] group, ≤970 Hounsfield unit [HU]; high density [HD] group, >970 HU). The patients' demographics, stone-related features, stone-free rates, and intraoperative and postoperative complication rates were compared between the groups. The primary objective was to evaluate whether the intraoperative and postoperative complication rates were higher in patients whose stone density was greater than 970 HU. Results: After propensity score matching, 170 of 210 LD and 170 of 263 HD patients undergoing RIRS were included. The baseline characteristics did not differ significantly between the groups. There were no significant differences between LD and HD patients with respect to intraoperative (5.9% and 8.8%, respectively; P = .29), postoperative (10.6% and 15.3%, respectively; P = .14), and overall complication rates (15.2% and 21.1%, respectively; P = .16). Stone-free status was achieved in 143 patients (84.1%) in the LD group and 148 patients (87%) in the HD group; the difference was not statistically significant (P = .27). Conclusion: Our results show that RIRS is a safe and effective minimally invasive procedure for the treatment of upper urinary tract stones, even in HD stones.Öğe The Effect of Gender on Sexual Behavior, Knowledge of Sexually Transmitted Diseases and Contraceptive Methods in College Students in Turkey(Ortadogu Ad Pres & Publ Co, 2010) Tanrıverdi, Gülbu; Ersay, Ahmet ReşitObjective: This study was conducted to examine the effect of gender on sexual behavior, sexually transmitted diseases (STDs) and contraceptive methods in college students in Turkey. Material and Methods: The research population was comprised of 396 students in a university school for Health College and Occupational School for health sciences. The sample was the 322 (81%) of the students who agreed to participate after being informed about the purpose of the study. The research data were analyzed using frequency distribution, chi-square analysis and independent sample t test. Results: According to the research results, the mean age for female students' first sexual intercourse was 18.85 +/- 2.16 and 16.76 +/- 2.31 years for males and females, respectively. It was determined that 24.0% of the male students and 13.7% of the female students had sexual intercourse; 59.5% of the male students and 19.6% of the female students reported that they masturbated. The same percentage of male and female students had insufficient information about sexually transmitted diseases. During sexual intercourse, 41.1% of female students' sexual partner and 58.3% of male students used a condom. Conclusion: As a result, in this study the male students had their first sexual intercourse earlier than the female students and had a higher percentage of having sexual intercourse (p< 0.05). However, any meaningful difference was not found between male and female students for the knowledge of STDs and the rates of using contraceptive methods (p> 0.05).Öğe Evaluation of YouTube Information Quality About Pes Planus(Amer Podiatric Med Assoc, 2024) Olcar, Haci Ali; Güngör, Berna; Kuru, Tolgahan; Aydin, Davut; Nusran, GürdalBackground: The aim of this study was to measure the quality of information about flatfoot and pes planus presented online on the social media site YouTube and to determine the trends of viewers to medical information on YouTube. Methods: Flatfoot and pes planus was typed into the YouTube search module. From the search results, videos with 50,000 views or more, longer than 45 seconds, and containing information about flatfoot and pes planus disease were selected. DISCERN and JAMA scoring, daily average views, number of likes, and number of comments were collected from 53 videos that met the criteria. The profession of the sharer was evaluated in terms of the information quality of the sharing and the orientation of the audience. Results: The mean number of views per day of the examined videos was 2,047. The mean video presentation time was 8 minutes 50 seconds. The mean JAMA score was 2 of 4 and the mean DISCERN score was 38.16 of 75. According to the DISCERN score according to the professions, the video quality was moderate for doctors (41.44 +/- 12.99), moderate for physiotherapists (41.91 +/- 9.04), poor for coaches (32.78 +/- 7.87), poor for patients (34.50 +/- 5.32), and weak for others (34.89 +/- 14.00). According to the Spearman correlation between DISCERN score and mean daily viewing, significant relationships were found for the doctors ( P = .0102) and others groups ( P = .0033); however, no significant relationships were observed for the physiotherapists group ( P = .1073), the flatfoot patients group ( P = .5363), and the coaches group ( P = .9111). There were significant relationships between like and comment counts in all groups (doctors, P = .0088; coaches, P = .0069; physiotherapists, P = .0007; others, P = .0018; and patients, P = .0066). Conclusions: Looking at previous studies, it was observed that the quality of online health information was historically inadequate. Likewise, in our study on YouTube, we found that the quality of flatfoot and pes planus information was poor to moderate. (J Am Podiatr Med Assoc 114(2), 2024; doi:10.7547/22-168)Öğe The history of surgery in disorders of sexual development(W.B. Saunders, 2021) Aldırmaz Ağartan, Canan.Öğe The effect of halofuginone and pirfenidone on wound healing in experimental glaucoma filtration surgery(Elsevier Masson s.r.l., 2021) Kasar, K.; Demir, T.; Akın, M. M.; Kobat, S. GüngörPurpose: To investigate the effects of halofuginone and pirfenidone on wound healing in experimental glaucoma filtration surgery (GFS). Study Design: Animal experimentation. Methods: A total of 42 male New Zealand albino rabbits were separated into 6 equal groups. A limbal-based trabeculectomy was performed on 5 groups, and Group I (control group) underwent no surgery and received no postoperative medication. For Group II (sham group), 1 drop 0.9% NaCl was instilled qid for 14 days. For Group III, 1% topical corticosteroid (prednisolone acetate) was instilled 1 drop qid for 14 days. For Group IV, 0.4 mg/mL mitomycin-C (MMC) was applied intraoperatively to the region of the scleral flap. For Group V, 0.5% pirfenidone was instilled 1 drop qid for 14 days postoperatively. For Group VI, a sponge soaked in 10 ng/mL halofuginone was applied to the surgical region for 3 mins. In addition, 1% topical corticosteroid was instilled × 1 drop qid for 14 days postoperatively for Groups IV, V and VI. After 14 days, sections prepared from the bleb regions of the enucleated eyes were evaluated histopathologically and immunohistochemically. Statistical analyses of the study were performed with Kruskal–Wallis variance analysis and the Mann–Whitney U test. Results: With regard to fibroblasts, suppression of the number of mononuclear cells and immunohistochemical staining intensity of transforming growth factor-b (TGF-β), fibroblast growth factor-b (FGF-β) and platelet derived growth factor (PDGF), the corticosteroid, MMC, pirfenidone and halofuginone groups were seen to exhibit more effect than the sham group (P < 0.05). Compared to the pirfenidone and fuginone groups, inhibition of fibroblast and monocyte proliferation was determined to be lower in the MMC group (P < 0.05). The intensity of TGF-β and FGF-β staining was seen to be lower in these two treatment groups than in the MMC group (P < 0.05). Conclusions: Halofuginone and pirfenidone may be used as effective alternative agents in delaying wound healing in glaucoma filtration surgery. © 2021 Elsevier Masson SAS Objectif: Étudier les effets de l'halofuginone et de la pirfénidone sur la cicatrisation après chirurgie expérimentale de filtration du glaucome (GFS). Conception de l’étude: Expérimentation animale. Méthodes: Un total de 42 lapins albinos mâles de Nouvelle-Zélande ont été séparés en 6 groupes égaux. Une trabéculectomie basée sur limbe a été appliquée à 5 groupes. Au groupe I (groupe témoin), aucune chirurgie ni aucun médicament postopératoire n'ont été appliqués. Au groupe II (groupe controle), 4 × 1 goutte de NaCl à 0,9 % ont été appliquées pendant 14 jours. Au groupe III, 1 % de corticostéroïde topique (acétate de prednisolone) a été appliqué 4 × 1 pendant 14 jours. Au groupe IV, 0,4 mg/ml de mitomycine-C (MMC) a été appliqué en peropératoire à la région du volet scléral. Dans le groupe V, 0,5 % de pirfénidone a été appliqué en goutte 4 × 1 pendant 14 jours postopératoires. Au groupe VI, une éponge imbibée de 10 ng/ml d'halofuginone a été appliquée sur la région chirurgicale pendant 3 minutes. De plus, 1 % de corticostéroïde topique a été appliqué 4 × 1 pendant 14 jours postopératoires aux groupes IV, V et VI. Au bout de 14 jours, les coupes préparées à partir des régions de la bulle des yeux énucléés ont été évaluées histopathologiquement et immunohistochimiquement. Une analyse statistique de l’étude a été réalisée avec l'analyse de variance de Kruskal-Wallis et le test U de Mann-Whitney. Résultats: En ce qui concerne les fibroblastes, la suppression du nombre de cellules mononucléaires et immunohistochimiquement, l'intensité de coloration du facteur de croissance transformant-b (TGF- β), le facteur de croissance des fibroblastes-b (FGF-β) et le facteur de croissance dérivé des plaquettes (PDGF), les groupes corticostéroïdes, MMC, pirfénidone et halofuginone se sont révélés plus efficaces que le groupe factice (p < 0,05). Par rapport aux groupes pirfénidone et fuginone, l'inhibition de la prolifération des fibroblastes et des monocytes a été déterminée comme étant plus faible dans le groupe MMC (p < 0,05). L'intensité de la coloration au TGF-β et au FGF-β s'est avérée plus faible dans ces deux groupes de traitement que dans le groupe MMC (p < 0,05). Conclusions: L'halofuginone et la pirfénidone peuvent être utilisées comme agents alternatifs efficaces pour retarder la cicatrisation des plaies en chirurgie de filtration du glaucome.Öğe Prediction of mortality in COVID-19 through combing CT severity score with NEWS, qSOFA, or peripheral perfusion index(W.B. Saunders, 2021) Akdur, Gökhan; Daş, Murat; Bardakçı, Okan; Akman, Canan; Sıddıkoğlu, Duygu; Akdur, Okhan; Akçalı, Alper; Erbaş, Mesut; Reşorlu, Mustafa; Beyazıt, YavuzIntroduction: The assessment of disease severity and the prediction of clinical outcomes at early disease stages can contribute to decreased mortality in patients with Coronavirus disease 2019 (COVID-19). This study was conducted to develop and validate a multivariable risk prediction model for mortality with using a combination of computed tomography severity score (CT-SS), national early warning score (NEWS), and quick sequential (sepsis-related) organ failure assessment (qSOFA) in COVID-19 patients. Methods: We retrospectively collected medical data from 655 adult COVID-19 patients admitted to our hospital between July and November 2020. Data on demographics, clinical characteristics, and laboratory and radiological findings measured as part of standard care at admission were used to calculate NEWS, qSOFA score, CT-SS, peripheral perfusion index (PPI) and shock index (SI). Logistic regression and Cox proportional hazard models were used to predict mortality, which was our primary outcome. The predictive accuracy of distinct scoring systems was evaluated by the receiver-operating characteristic (ROC) curve analysis. Results: The median age was 50.0 years [333 males (50.8%), 322 females (49.2%)]. Higher NEWS and SI was associated with time-to-death within 90-days, whereas higher age, CT-SS and lower PPI were significantly associated with time-to-death within both 14 days and 90 days in the adjusted Cox regression model. The CT-SS predicted different mortality risk levels within each stratum of NEWS and qSOFA and improved the discrimination of mortality prediction models. Combining CT-SS with NEWS score yielded more accurate 14 days (DBA: −0.048, p = 0.002) and 90 days (DBA: −0.066, p < 0.001) mortality prediction. Conclusion: Combining severity tools such as CT-SS, NEWS and qSOFA improves the accuracy of predicting mortality in patients with COVID-19. Inclusion of these tools in decision strategies might provide early detection of high-risk groups, avoid delayed medical attention, and improve patient outcomes.Öğe New design titanium miniplate in mandibular angle fracture treatment: a biomechanical study(Springer Science and Business Media Deutschland GmbH, 2021) Şimşek, Tuğçe; Erdoğan, Mehmet Mustafa; Uğur, Levent; Kazaz, Hasan; Tezcan, Erkan; Seyhan, SinanAngle mandible is one of the most common fractures in the mandible. Fractures of the angle mandible are one of the most problematic areas in the facial area due to the high frequency of complications and difficult access to the surgical site. Although there are many available miniplates and screws with several geometrical models for use in mandibular angle fractures, geometrical features of these materials and the optimal number and site of placement of plates have yet to be determined. An ideal plate should be durable and potent enough to endure the functional burden. This study employed 12 mandible replicas made of rigid polyurethane resin used with appropriately standardized measurements. A full-thickness fracture line was present on the angle of all mandible replicas. Four groups were formed. In the our study, mandibular angle fracture line was fixed with parallel two straight plates, a butterfly plate, a square plate, and a newly designed three-dimensional (3D) hourglass-shaped plate. Fixation was performed with a different miniplate in each group. Three samples were formed from each group. Each model was subjected to a compression test at a displacement-controlled loading. Loading was continued after maximum load was reached. The latter revealed a significant difference between the newly designed plate and the other three plates (p < 0.05). In conclusion, we suggest that with the newly designed plate, which was used for the first time in the our study and showed a greater resistance in mandibula fractures, designed plate application will be more effectively used in clinical practice.Öğe The effect of meteorological variables on spontaneous pneumothorax in two regions with different altitudes(Springer Science and Business Media Deutschland GmbH, 2021) Daş, Murat; Alar, Timuçin; Delice, Orhan; Gedik, İsmail Ertuğrul; Bardakçı, Okan; Akman, Canan; Ulaş, Ali Bilal; Akdur, OkhanSpontaneous pneumothorax (SP) is defined as the presence of free air inside the pleural space. Many studies have reported that meteorological variables may trigger SP, but the mechanism is unknown. The aim of this study was to compare the effects of meteorological variables on the development of SP in two regions with different altitudes. The study was conducted in the Çanakkale (2 m above sea level) and the Erzurum region (1758 m). A total of 494 patients with SP who presented to the hospitals of the two regions between January 2011 and December 2016 were included in the study. The meteorological variables used included ambient temperature, atmospheric pressure, relative humidity, precipitation amount, wind speed, and wind direction (as north and south). The total 2192 days were divided into two as days with and without an SP case presentation. A 4-day period prior to the day a case presented was compared with the other days without any cases to investigate the presence of any lagged effect. Statistical significance was accepted at p < 0.05. Comparison of these two regions showed a significant difference between them. The meteorological variables of the regions that affect SP development were found to be low mean minimum temperature, high daily temperature change, low precipitation, low wind speed and north winds for Erzurum, and only rainy days for Çanakkale. The results have demonstrated that cold weather, sudden temperature changes, north winds, and low wind speed are risk factors for the development of SP at high altitudes.Öğe Assessment of functional and aesthetic outcomes in septorhinoplasty(Springer Science and Business Media Deutschland GmbH, 2021) Şimşek, Tuğce; Erdoğan, Mehmet Mustafa; Özçetinkaya Erdoğan, Serap; Kazaz, Hasan; Tezcan, Erkan; Seyhan, SinanPurpose: The aim of this study is to review the aesthetic and functional outcomes of septorhinoplasty using questionnaires that have never been collectively used, as well as surgeons’ evaluation. Materials and methods: Our study was conducted prospectively among 100 patients who underwent septorhinoplasty operation. We evaluated the effects of septorhinoplasty’s functional and aesthetic outcomes on patients' emotional status using a combination of NOSE, ROE, DAS-24, and GBI questionnaires as well as surgeons’ evaluations. Results: Our study did not detect any significant difference between preoperative and postoperative levels of patient satisfaction with regard to age, sex, and surgery type and the number of surgeries. Our study, on the other hand, revealed significantly higher postoperative GBI scores among patients with higher preoperative DAS-24 and NOSE scores. However, we showed no significant difference between the preoperative ROE score and postoperative GBI score Conclusion: This study demonstrated that septorhinoplasty can not only significantly alter a nose’s functional and aesthetic appearance, but it can also boost patient satisfaction.Öğe The effects of systemic ozone application and hyperbaric oxygen therapy on knee osteoarthritis: an experimental study in rats(Springer Science and Business Media Deutschland GmbH, 2021) Yılmaz, Onur; Bilge, Ali; Erken, H. Yener; Kuru, TolgahanObjective: To evaluate the effects of systemic medical ozone (O3) application and hyperbaric oxygen (HBO) therapy on surgically induced knee osteoarthritis (OA) in a rat model. Materials and methods: We performed anterior cruciate ligament transection (ACLT) in order to create experimental OA in the right knees of 27 male rats. The left knee joints of all rats were sham-operated without ACLT as the negative control group. The rats were randomly assigned into three groups: (1) control group, which received no treatment; (2) O3 group, which received intraperitoneal 30 μg medical O3; (3) HBO group, which received HBO therapy for 60 minutes twice a day. We sacrificed the rats on the tenth week after the operation. We evaluated the degree of OA using Mankin scores. Results: As a result of histopathological examination, the mean Mankin scores in the right knees with ACLT were 8.17 ± 2.12 in the control group, 6.22 ± 1.56 in the HBO group, and 4.72 ± 1.30 in the O3 group. The differences between the O3 group and the HBO group and the O3 group and the control group were found to be statistically significant (p 0.001, p 0.039, respectively). There was no difference between the HBO group and the control group (p 0.086). Conclusions: The results of the present study show that systemic medical O3 application was more effective than HBO therapy and may reduce development of cartilage damage and prevent OA formation.Öğe Development of melatonin-embedded PLGA-PEG6000 nanofiber biomaterial, and investigation of the effects on abdominal adhesion formation(SAGE Publications Ltd, 2024) Gökçe, Oruç Numan; Aykora, Damla; Danışman, Merve; Demir, Ufuk; Aydeğer, Cemre; Süner, Salih Can; Oral, Ayhan; Karaboğa, İhsan; Uzun, MetehanAbdominal adhesions are still among the most common postsurgical peritoneal inflammation-related complications. Adhesion-related disorders are still highly costly and prevalent due to advances in surgical techniques, treatment methods, and various drugs. The present study aimed to investigate the effects of Poly (D,L-lactide-co-glycolide) (PLGA)- polyethylene glycol (PEG6000) Nanofiber + Melatonin on the abdominal adhesion model in rats. For this purpose, PLGA-PEG6000 Nanofiber + Melatonin matrix was fabricated and implanted in an experimental abdominal adhesion model in rats. Our study consisted of an in vitro and an in vivo part. The degradation and release profile of the matrix and Melatonin (Mel) embedded matrix was performed in vitro. In vivo, the procedure was carried out with 18 Wistar male rats. Rats were divided into three groups as follows: Sham, Matrix, and Mel + Matrix, respectively. Consequent to degradation and release profiling in vitro, an experimental adhesion model was created and fabricated pure matrix (2 × 2 cm2), and matrix (2 × 2 cm2, 0.25 mg melatonin/per matrix embedded) was applied to injury area in related groups. Intra-abdominal adhesion scores were determined on post-op 21st day, under general anesthesia. Following, cecum, peritoneal tissue, and adhesive bands were harvested. Macroscopic analysis (severity of adhesion formation), Hematoxlyn&Eosin and Masson’s Trichrome staining (for the examination of the levels of infiltration of inflammatory cells, fibrosis, and neovascularization) were performed for the evaluation of the effects of Mel embedded and pure matrix Our results indicated that PLGA-PEG6000 Nanofiber + Melatonin matrix was degraded completely in rats abdominal cavity and significantly reduced adhesion formation compared to other groups macroscopically (p < 0.05). On the other hand, the histopathological analysis indicated that the fabricated matrix reduced inflammatory cell infiltration, fibrosis, and neovascularization levels.Öğe Thyroid fine-needle aspiration cytology: malignancy rate in the category of indeterminate significant atypia/indeterminate significant follicular lesion(King Faisal Specialist Hospital and Research Centre, 2024) Kaya Terzi, Neslihan; Terzi, TolgaBACKGROUND: Fine needle aspiration cytology (FNAC) is a standard preoperative diagnostic modality for thyroid nodules. The Bethesda Thyroid Cytopathology Reporting System (TBSRTC) defines the FNAC atypia group as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS). OBJECTIVES: Determine the risk of malignancy after surgical resection in patients with AUS/FLUS. DESIGN: Retrospective SETTING: Pathology department of a tertiary care center PATIENTS AND METHODS: All thyroid FNACs between 2015 and 2023 that were diagnosed as AUS/FLUS in Turkey. Patient demographics, preoperative ultrasonographic features, and follow-up data were collected.Öğe The Effect of Ureteral Access Sheath Use/Caliber Change on Outcomes of Retrograde Intrarenal Surgery, Short-Term Kidney Functions, Radiation Exposure, Ureteroscope Lifetime, and Factors Predicting Insertion Failure: A RIRSearch Study(Mary Ann Liebert Inc., 2024) Özman, Oktay; Akgül, Murat; Başaataç, Cem; Cakır, Hakan; Çınar, Önder; Sancak, Eyüp BurakBackground: The aim of this study was (1) to explore effect of ureteral access sheath (UAS) use on primary retrograde intrarenal surgery (RIRS) outcomes, short-term kidney functions, radiation exposure, and ureteroscope lifetime (URS-LT) and (2) to reveal factors that predict UAS insertion failure.Materials and Methods: Patients (n = 1318) who underwent RIRS without UAS (Group 1), those who had operation with a <11-13 Fr (Group 2), and those with a >= 11-13 Fr UAS were matched (1:1:2) and compared. Stone-free rate (SFR), intra- and postoperative complications, acute kidney injury (AKI), fluoroscopy time, URS-LT, and UAS insertion failure were the outcomes.Results: SFR, which was highest in Group 3 (75%, 71% and 87.3%, respectively; P = .001), was significantly associated with use of >= 11-13 Fr (odds ratio [OR]: 4.2, P < .001), but was not with use of <11-13 Fr UAS (OR: 1.3, P = .3). Group 3 had less need for auxiliary procedure (15%, 16%, and 7.4%, respectively; P = .03). Five percent of patients had a risk of AKI, but only 0.3% developed AKI. Although UAS use was protective against creatinine increase (OR: 0.65, P = .02), increased risk of AKI waas only associated with female gender (OR: 5.5, P < .001). Fluroscopy times were 5, 15, and 87 sn, respectively (P < .001). Short URS-LT was strongly associated with high frequency of lower calix stones (r = -0.94, P = .005), but URS-LT was not correlated with sheathless case rate (r = 0.59, P = .22). UAS insertion success in first attempt was more likely in younger (OR: 0.99, P = .03), hydronephrotic (OR: 3.4, P < .001), and female cases (OR: 1.5, P = .008). But absolute UAS insertion failure was associated with female gender (OR: 2.7, P = .017).Conclusions: Not any UAS use but a higher caliber UAS use may improve SFR and protect against AKI after RIRS. Although UAS insertion failure is seen mostly in men, it may be more challenging in women owing to less efficacy of preoperative Double-J stent.Öğe Synthesis and characterization of poly(Maltodextrin) microgel from maltodextrin as drug delivery system(Elsevier B.V., 2024) Şahiner, Mehtap; Güngör, Buket; Sılan, Coşkun; Demirci, Şahin; Erdoğan, Hakika; Ayyala, Ramesh S.; Şahiner, NurettinMicrogels of maltodextrin (MDex) as poly(maltodextrin) (p(MDex)) were prepared by reverse-micelle crosslinking technique at various crosslinking ratios, 25, 50, and 100% based on the repeating unit of MDex using divinylsulfone (DVS) as crosslinker and were designated as p(MDex)-1, p(MDex)-2, and p(MDex)-3 respectively. The prepared p(MDex) microgels were blood compatible with <2% hemolysis and > 80%blood clotting index values at 1.0 mg/mL concentration. Also, p(MDex) microgels were found as biocompatible with >90% cell viability against L929 fibroblast cells at 1.0 mg/mL concentrations. Furthermore, p(MDex)-3 microgels were modified with ethylenediamine (EDA) and pentaethylenehexamine (PEHA) to generate new amine groups on microgels surface to obtain p(MDex)-EDA and p(MDex)-PEHA, respectively to render new surface functionality and features. The drug delivery potentials of p(MDex)-3, p(MDex)-EDA, and p(MDex)-PEHA microgels were tested employing amoxicillin (Amox) for loading and release studies at pH 7.4 and 37 degrees C. Higher drug loading amount, loading content%, and encapsulation efficiency% values were attained for p(MDex)-PEHA microgels with 112.5 +/- 9.9 mg/g, 12.8 +/- 1.1%, and 63.4 +/- 4.1%, respectively. The Amox-loaded p(MDex)-3, p(MDex)-EDA, and p(MDex)-PEHA microgels released 90.8 +/- 0.9, 86.2 +/- 10.8, and 87.2 +/- 9.6% of the loaded Amox at pH 7.4 PBS in 125 h. Controlled and extended drug delivery system at the therapeutic window is of paramount significance in treatment of various diseases. P(MDex)-PEHA microgels revealed almost a linear Amox release profile for up to 28 h. The Amox release from the p(MDex) microgels was fitted with the Korsmeyer-Peppas model with n values <0.5.Öğe Treatment of Granulomatous Mastitis With Steroids: Should the Decision to End the Treatment be Made Radiologically?(Turkish Federation of Breast Diseases Societies, 2024) Çetin, Kenan; Sıkar, Hasan Ediz; Feratoğlu, Fatih; Taşdoğan, Bağış; Gülluoğlu, Bahadır M.Objective: Idiopathic granulomatous mastitis (IGM) is a benign inflammatory breast disease of unknown etiology that affects women in their reproductive period. The most commonly preferred option as first-line treatment is steroids, but the lack of a standard treatment protocol and high recurrence rate after treatment constitutes a recurring challenge during its management. The aim of this study was to investigate whether the decision to end the treatment should be made radiologically or clinically.Materials and Methods: This retrospective cohort study included IGM patients who had complete clinical recovery with steroids and were followed for a minimum of 30 months. Patient demographics, disease severity and findings, treatment regimens and duration, and magnetic resonance imaging (MRI) findings at clinical recovery were assessed for their relation to recurrence.Results: Eighty-nine patients who were clinically completely healed after steroid treatment for IGM were included in the study. At the time of clinical healing, 51 (57.3%) patients had a complete radiological response and 38 (42.7%) had a partial radiological response (PRR) on MRI. Overall, recurrence developed in 22 (24.7%) patients after a median 38.6-month follow-up. Patients who experienced recurrence were significantly older and had PRR when their treatment was stopped upon clinical healing. Conclusion: During the process of clinical healing, the imaging findings revealed that the remaining disease seems to be a significant predictor for recurrence in IGM patients. In patients with PRR, extending the treatment with either prolonged steroid therapy or by surgical excision of the occult residual disease may prevent recurrences in IGM patients.
